The never-ending political fight over health care hit the Supreme Court Wednesday, and insurance coverage for millions of Americans is on the line.

Didn't we do this already?

Yes, but foes of President Barack Obama's signature law hope this time the justices will gut "Obamacare." The law's defenders say it's a trumped-up attack.

Still sound familiar? Actually, a lot has changed since the Supreme Court's big health care decision of 2012.

Five ways this time is different:

PEOPLE ALREADY ARE USING THE HEALTH CARE PLANS

The first case came as major parts of the law were being phased in. The promised subsidies to help low- and middle-income families afford insurance were not available.

Now the law is in its second year of providing coverage to people who are not insured through their jobs. More than 11 million people are enrolled; nearly 9 out of 10 receive tax subsidies to help cover the cost.

If the Supreme Court rules against the government, many would be unable to afford their premiums.

See the rest here:

Health Care at the High Court: 5 Ways This Time Is ...